Sleep Deprivation May Actually Improve Depression

Sleep deprivation may sound like a form of torture for some, but in controlled scientific settings, it has been found to be a fast-acting treatment for depression. In a recent meta-analysis done by the Perelman School of Medicine at the University of Pennsylvania, sleep deprivation reduced depression symptoms in about half of the subjects treated. Partial sleep deprivation, defined as 3-4 hours of sleep followed by 20-21 hours of forced wakefulness was just as effective as total sleep deprivation (36 hours). Medication did not significantly affect the results. While medication is the most commonly used treatment for depression, sleep deprivation in a 24 hour period can improve symptoms of depression much faster. Antidepressant medications, on the other hand, typically take 6-8 weeks or more to take effect. Sleep deprivation may improve the symptoms of depression in over 16 million people that suffered from major depressive episodes in 2014. Despite over 75 earlier studies in support of sleep deprivation and depression, the response rate of sleep deprivation has not been evaluated since 1990.While the beneficial effects of sleep deprivation were recognized over 30 years ago, researchers still do not appear to fully understand how effective the treatment is or how to reach the best clinical results. The analysis done by associate psychology professor Philip Gehlman of the Penn Sleep Center is able to report how effective sleep deprivation is and which populations would benefit from such a treatment. After evaluating over 2,000 studies, the team of researchers extracted information from 66 studies over a 36-year time frame. The group looked at type and timing of sleep deprivation (early vs late, partial vs full), clinical sample (major depression, manic episodes or both), age, gender and medication status of individuals. They also evaluated the definitions of sleep deprivation across studies and how they differed.The studies in their analysis indicated that sleep deprivation is useful for several populations. Response rate was equal regardless of type of depression or how sleep deprivation was enforced. Ongoing research is necessary to pinpoint exactly how deprivation of sleep offers a quick and impactful reduction in depression symptoms. Future studies should also have a more comprehensive evaluation of possible predictors of outcomes of treatment from sleep deprivation to assess which patients are most likely to benefit.If you or someone you know suffers from depression, it may be worth talking to a healthcare provider about how to incorporate sleep deprivation into your treatment.  If you’re having trouble getting to sleep or staying asleep, avoid caffeine after 2 PM and stop eating a few hours prior to bedtime. Alcohol consumption can also disrupt sleep and may impact depression further.By Lisa Andrews, MED, RD, LDReferences:

1. Elaine M. Boland, PhD; Hengyi Rao, PhD; David F. Dinges, PhD; Rachel V. Smith, PhD; Namni Goel, PhD; John A. Detre, MD; Mathias Basner, MD, PhD; Yvette I. Sheline, MD; Michael E. Thase, MD; and Philip R. Gehrman, PhD. Meta-Analysis of the Antidepressant Effects of Acute Sleep Deprivation.  J. Clinical Psychiatry.  10.4088/JCP.16r11332.
2. https://www.scientificamerican.com/article/why-sleep-deprivation-eases-depression/

Printable Handout: Sleep and Depression Handout